On June 28, 2014, Governor Snyder signed a new comprehensive law imposing significant regulations on compounding pharmacies and pharmacists that compound both sterile and non-sterile pharmaceuticals including criminal sanctions for certain violations. This new law took September 26, 2014 (i.e., 90 days from the date it was signed into law). The law was in response to growing concerns on the safety of sterile compounding after the New England Compounding Center (NECC) fiasco arose in the Fall of 2012 wherein an outbreak of rare fungal meningitis was reported throughout the United States and the etiology was traced by the Centers for Disease Control and Prevention (CDC)to contaminated epidural steroid injections packaged and marketed by NECC, a compounding facility in Massachusetts. Of the 20 states adversely affected, Michigan had the highest number of fungal infections (264) and the highest number of related fatalities (19) according to the CDC (see http://www.cdc.gov/hai/outbreaks/meningitis-map-large.html).
The new law amends Part 161 (General Provisions) and Part 177 (Pharmacy Practice and Drug Control) of the Public Health Code and includes, but is not limited to the following changes:
(1) a person providing compounding services in Michigan is required to be licensed as a pharmacy or manufacturer, and an outsourcing facility is required to be licensed as a pharmacy;
(2) an applicant for a pharmacy license for a pharmacy that would provide compounding services for sterile pharmaceuticals is required to submit verification of current accreditation through a national accrediting organization (e.g., PCAB);
(3) an application process and standards for a pharmacist or pharmacy compounding pharmaceuticals are to be created for a prescriber, health facility, or agency without a prescription;
(4) a pharmacist is prohibited from compounding commercially available pharmaceuticals unless the commercially available pharmaceutical was modified to produce a significant difference and was not available in normal distribution channels to meet the patient’s needs in a timely manner;
(5) a pharmacy is required to notify the Department of Licensing and Regulatory Affairs (LARA) of a complaint regarding compounding activities filed by another state for violation of that state’s pharmacy laws, an investigation by Federal authorities regarding a violation of Federal law, or an investigation by any agency into a violation of accreditation standards, within 30 days of knowledge of the investigation or complaint;
(6) an out-of-State applicant or licensee is required to reimburse LARA for expenses incurred in an inspection or investigation of the applicant or licensee;
(7) LARA is required to maintain, post, and update on a quarterly basis, a list of pharmacies and pharmacists authorized to compound pharmaceuticals for a prescriber, health facility, or agency;
(8) LARA has the authority to promulgate rules regarding conditions and facilities for compounding pharmaceuticals;
(9) a pharmacist is required to maintain records of compound sterile pharmaceuticals;
(10) a pharmacy, manufacturer, or wholesale distributor is required to designate a licensed pharmacist as the pharmacist in charge (PIC), and establish the duties of a PIC;
(11) certain applicants for new pharmacies, manufacturers, or wholesale distributors are required to undergo a criminal history check;
(12) there are criminal penalties imposed for violations of certain statutory provisions and requirements; and (13) LARA may summarily suspend a pharmacy license if it receives a notice of imminent risk to public health or safety from the FDA or the CDC.
The new law in its entirety is available at: http://www.legislature.mi.gov/documents/2013-2014/publicact/pdf/2014-PA-0280.pdf.
Robert S. Iwrey Esq., a founding partner of The Health Law Partners, P.C., practices in all areas of healthcare law and devotes a substantial portion of his practice assisting clients in pharmacy legal matters including compliance, third party payor audits, government investigations, state licensing and DEA registrations. For more information regarding this article, please contact Robert S. Iwrey, Esq. at (248) 996-8510 or (212) 734-0128 or firstname.lastname@example.org.